AAP issues statement on cochlear implants

Children preparing for cochlear implant surgery should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza at least 2 weeks before surgery, according to a recent policy statement from the American Academy of Pediatrics published in the July 26 online issue of Pediatrics.

Cochlear implants increase the risk of acute otitis media and bacterial meningitis, especially during the first 2 months after implantation. Doctors should watch for signs of these conditions and treat immediately with a parenteral antibiotic (eg, ceftriaxione or cefotaxime).

"Watchful waiting" without antimicrobial therapy is inappropriate for children with implants with acute otitis media, according the statement. After acute otitis media develops, bacteria can enter the inner ear through an incompletely sealed cochleostomy. Patients with meningitis should be urgently evaluated by an otolaryngologist for consideration of imaging and surgical exploration.